STATE OF _______(11)_________)
)
COUNTY OF ______(12)_________)
The foregoing instrument was acknowledged before me this _(13)_ day
of _____(14)_______, 19_(15)_, by ________(16)_________ as
Purchaser.
____________(17)______________
Notary Public
My Commission Expires: _________________
NOTICE
The information in this document is designed to provide an outline that you can follow
when formulating business or personal plans. Due to the variances by many local, city, county
and state laws, we recommend that you seek professional legal counseling before entering into
any contract or agreement.